REVIEW Part I: A First-Rate Madness: Uncovering the Links between Leadership and Mental Illness

A First-Rate Madness:

Uncovering the Links between Leadership and Mental Illness

By Nasir Ghaemi, M. D.

Review by John E. Wade II

REVIEW Part I

This is a fascinating book, explaining in a compelling manner how some of the greatest leaders of the past two centuries—Abraham Lincoln, Gen. William T. Sherman, Winston Churchill, Mohandas Gandhi, Franklin D. Roosevelt, John F. Kennedy, Dr. Martin Luther King, Jr., and Ted Turner among others—drew from their personal suffering to evoke sterling leadership abilities under the harshest circumstances. The author also addresses the “flip side,” that is, weak leaders such as Neville Chamberlain who didn’t perceive the threat of Adolf Hitler. He also presents a disturbing account of Hitler and his untreated and mistreated bipolar disorder, as well as the top echelon of his command who carried out his evil orders.

I urge everyone to read the complete book to come to understand, as I do, that unusual times call for extraordinary leadership, whereas ordinary times are better served by leaders who help “the trains run on time,” whether political, military or business.

For crisis leadership, bipolar disorder (with its mania and depression) can present vital elements of effectiveness, such as realism, resilience, empathy and creativity. Depression invokes all four of those elements while mania promotes creativity and resilience. Personally, I’d like to add one more quality to the three “high” states that the author presents (hyperthymia seen in Franklin D. Roosevelt (FDR hereafter) and John F. Kennedy (JKF hereafter); hypomania exhibited by Churchill; and mania in Sherman and Turner), that of high energy.

Let’s go through the book with an open mind and a certain sense of awe that these leaders (excluding Hitler, of course) performed in a superb way beyond the limits where many in that situation would give up, as FDR with polio and JFK with Addison’s disease.

The book examines eight great leaders in “politics, military and business whose lives and work demonstrate various dimensions of the link between leadership and madness: General William Tecumseh Sherman of Civil War fame; Ted Turner; Winston Churchill; Abraham Lincoln; Mahatma Gandhi; Martin Luther King, Jr., Franklin D. Roosevelt (FDR); and John F. Kennedy (JFK).” He also presents counterexamples of healthy “normal” leaders who failed in time of crisis: Richard Nixon, General George McClellan and Neville Chamberlain.

In this review I will not include all the figures that Dr. Ghaemi addresses, but will try to illustrate how democratic societies might have come to the point that only “normal” candidates can rise to great leadership even though such persons with depression (Lincoln and Churchill), creativity (Sherman and Turner), depression coupled with radical empathy (Gandhi and King), and resilience (FDR and JFK) can rise as necessary to handle times of great crisis.

The author, Nassir Ghaemi, M. D., is a professor of psychiatry at Tufts University School of Medicine. He trained in psychiatry at Harvard Medical School, holds degrees in history (BA, George Mason University), philosophy (MA, Tufts) and public health (MPH, Harvard).

In identifying and analyzing these prominent individuals he used four criteria: symptoms, genetics, cause of illness and treatment. I will not duplicate his application of those telling standards on each figure, but I will say that I found his methodology and thoroughness completely convincing.

The author explains that “… mental illness doesn’t mean that one is simply insane, out of touch with reality, psychotic. The most common mental disorders usually have nothing to do with thinking at all, but rather abnormal mood: depression and mania. These moods aren’t constant.”

There is a growing “depressive realism hypothesis” which points out that “… depressed people aren’t depressed because they distort reality; they’re depressed because they see reality more clearly than other people do.” This applies to Winston Churchill as he vividly saw the great threat of the rise of Adolf Hitler.

Mania can be accompanied by “… creativity, energy and sociability….” but if it is too pronounced it can lead to “… irritability, promiscuous sexuality, and lavish spending.” The core of mania is “impulsivity with heightened energy.”

An early twentieth century German psychiatrist, Erst Kretschmer, said “Insanity is not a regrettable … accident but the indispensable catalyst of genius.” The author states categorically that “The best crisis leaders are the mentally ill or mentally abnormal; the worst crisis leaders are mentally healthy.” When writing of these crisis leaders he states, “The weakness is, in short, the secret of their strength.”

Just a brief comment about Sherman, a Union general who broke the back of the Confederacy with his unprecedented march through Georgia—burning Atlanta—on to Augusta, with similar tactics all the way through South Carolina to North Carolina. “A month later, the war was over.” Despite his mental breakdowns in the past, “With all this military success, Sherman had rehabilitated his image from crazy failure to insane genius.”

Creativity in any realm is not just solving old problems, but finding new problems to solve. “Mania enhances both aspects of creativity: the divergence of thought allows one to identify new problems, and the intense energy keeps one going till the problem is solved.”

Let’s briefly address Ted Turner, a legend in his own time in many ways. The author states “I believe Turner was a success because of, rather than despite, his bipolar symptoms.” Turner’s “… manic energy and creativity are relatively clear.”

Interestingly, the author relates that Leston Havens, a wise psychotherapist, once commented that he had known many people who had been improved by failure, and many ruined by success. Failure deflates illusion, while success only makes illusion worse. That’s a powerful assessment of human nature. The author explains how early hardships in life—particularly harsh ones—tend to produce, “not infrequently, our greatest leaders.”